Pathogenesis-Driven Advances in Diagnosis and Treatment of Sjögren Disease

Sjögren disease (SjD) is a chronic systemic autoimmune disorder characterized by immune-mediated injury to exocrine glands and multiple extraglandular organs, affecting millions of individuals worldwide. Despite its clinical burden, SjD remains challenging to diagnose in a timely manner because of the limited availability of objective diagnostic tools and the lack of knowledge in its pathogenic mechanisms, which also hinders the development of targeted therapy. Current therapeutic strategies include systemic immunosuppressive agents and corticosteroids, supplemented by symptomatic management; however, these approaches offer variable efficacy and induce systemic adverse effects. This review summarizes recent advances in the clinical diagnosis of SjD, emphasizing evolving diagnostic criteria and advanced diagnostic tools, including ultrasonographic imaging, biopsies, as well as tear/salivary and hematological biomarkers; and discusses current concepts of SjD pathophysiology, focusing on immune dysregulation, inflammatory signaling, and tissue-specific pathologic changes. Moreover, novel therapeutics targeting pattern recognition receptors and lymphocytic activation were included.